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目的:探讨超声图像对结节性甲状腺肿伴甲状腺癌的诊断价值。方法:选择2010年6月至2012年8月就诊的216例甲状腺肿的患者作为研究对象,进行二维超声、彩色多普勒超声检查以及病理组织活检等。结果:超声诊断的结果准确率为54.72%。术前超声诊断的结果显示,58例为结节性甲状腺肿合并甲状腺癌,恶性结节共104个;158例为结节性甲状腺良性结节,良性结节共296个。术后活组织病理检查显示,106例患者为结节性甲状腺肿合并甲状腺癌,恶性结节共为172个;110例为结节性甲状腺良性结节,良性结节共208个。两组超声图像上结节的回声、形态以及钙化情况比较,差异有统计学意义(P<0.05)。恶性结节血流多为Ⅱ级以上,而良性结节血流多为Ⅰ级和Ⅱ级,两者的血流分级情况比较,差异有统计学意义(P<0.05)。结论:二维超声及彩色多普勒检查对结节性甲状腺肿合并甲状腺癌患者的诊断检出率较高,进行超声检查时应重点扫描结节的回声、钙化情况、周边及内部的血流等等,如有必要,可进行超声引导下的穿刺病理组织活检,提高诊断的准确性。
Objective: To investigate the diagnostic value of ultrasound in the diagnosis of nodular goiter with thyroid cancer. Methods: A total of 216 patients with goitre treated from June 2010 to August 2012 were enrolled in the study. Two-dimensional ultrasonography, color Doppler ultrasonography and pathological biopsy were performed. Results: The accuracy of ultrasonic diagnosis was 54.72%. The results of preoperative ultrasonography showed that 58 cases were nodular goiter with thyroid cancer, a total of 104 malignant nodules; 158 cases of nodular thyroid benign nodules, a total of 296 benign nodules. Postoperative biopsy showed 106 cases of nodular goiter with thyroid cancer, a total of 172 malignant nodules; 110 cases of nodular benign thyroid nodules, a total of 208 benign nodules. There was significant difference in echogenicity, morphology and calcification between the two groups of nodules (P <0.05). Malignant nodules were mostly grade Ⅱ or higher, while benign nodules were mostly grade Ⅰ and Ⅱ. There was significant difference in blood flow classification between the two groups (P <0.05). Conclusion: Two-dimensional ultrasonography and color Doppler ultrasound detection of nodular goiter in patients with thyroid cancer detection rate is higher, the ultrasound examination should focus on scanning nodules echo, calcification, peripheral and internal blood flow And so on, if necessary, ultrasound-guided biopsy of the punctured pathological tissue to improve the diagnostic accuracy.